Pleural abrasion should not routinely preferred in treatment of primary spontaneous pneumothorax

Primary spontaneous pneumothorax (PSP) is a significant global health problem, with reported yearly incidence of 18.0–28.0 per 100,000 in men and 1.2–6.0 per 100,000 in women (1). The main purpose of PSP treatment is to prevent its recurrence. Though various methods have been used in PSP treatment, including simple aspiration, chest drainage, bullectomy, medical pleurodesis, and surgical pleurodesis (2-4), bullectomy with surgical pleurodesis (abrasion, pleurectomy, surgical chemical pleurodesis, et al.) under video-assisted thoracoscopy (VATS) was the most popular operative technique in PSP treatment due to its low recurrent risks (2–14%) (3,5,6). While recently a lot more evidence have shown that pleurodesis could not lower the recurrence rate of PSP (7). Besides, it might introduce the risk of bleeding and of injury to surrounding structures, which could lead to more postoperative drainage, prolonged in-hospital stay, and extra medical related cost